Prevalence and clinical characteristics of a high cardiac output state in patients with multiple myeloma

Article Abstract:

Multiple myeloma is a cancer in which several tumors form in the bone and bone marrow. This cancer may be associated with the development of congestive heart failure, the inability of the heart to pump blood, leading to congestion of the lungs. In high output heart failure, the volume of blood pumped by the heart is greater than expected in heart failure. High output heart failure was recently reported in three patients with multiple myeloma who did not have severe anemia or medical conditions that would cause high cardiac output, such as hyperthyroidism (increased activity of the thyroid gland). The mechanisms underlying the development of high output heart failure in these patients are not known. The prevalence and clinical characteristics of patients who had high cardiac output associated with multiple myeloma were assessed. A high cardiac output state was defined as a cardiac index of greater or equal to 4.0 liters per minute per square meter. Known causes of high cardiac output could not be identified in eight patients with this condition. Four of these individuals developed high output congestive heart failure, including two patients who died. Severe bone disease occurred in all eight patients with high cardiac output, but only in 9 of 26 patients with normal or low cardiac output. The results show that high cardiac output states are common among patients with multiple myeloma and are accompanied by severe bone disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Causes of, Bone diseases, Congestive heart failure, Cardiac output

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A structurally aberrant immunoglobulin paraprotein in a patient with multiple myeloma and corneal crystal deposits

Article Abstract:

The formation of protein crystals in the cornea, the covering over the front portion of the eyeball, is called crystalline keratopathy. This eye disorder may be a symptom of multiple myeloma, a cancer of the bone marrow, and other monoclonal gammopathies, diseases in which there is an increase in blood levels of immunoglobulins, which are specialized proteins involved in immune responses. The nature of paraproteins or abnormal proteins in crystalline keratopathy is not known. A case is described of a 59-year-old man with multiple myeloma who developed rapidly progressive crystalline keratopathy. The paraproteins detected in the blood, cornea, and aqueous humor, a fluid within the eye, were analyzed by various biochemical techniques. The results indicated the presence of an unusual immunoglobulin with an abnormal structure, including altered sulphur-containing bonds between the molecules of this protein. Alterations of protein structure may be responsible for crystallization of these paraproteins. Thus, the change in the chemical structure of this paraprotein may contribute to the disease process of crystalline keratopathy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Immunoglobulins, Corneal diseases

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Complement abnormalities in multiple myeloma

Article Abstract:

Multiple myeloma is a cancer of blood cells, characterized by multiple tumors in bone marrow and the secretion of a protein associated with depressed immunoglobulin levels which causes the patient to be susceptible to infection. Recurrent bacterial infections are the most frequent cause of serious illness and death in patients who are diagnosed with multiple myeloma. Abnormalities of the immune system are investigated in which specific complements (blood proteins) are normally activated and deposited around antigens which have been marked by antibody (antigens provoke an immune response and antibodies fight infection). The mechanism which causes Complement 3 (C3) to fail to function properly in multiple myeloma could not be explained on the basis of a single abnormality; it is probably due to several different complement abnormalities. Complement defects play a role in the inability of the immune system to defend itself from infectious antigens in patients with multiple myeloma.

Research, Immunological deficiency syndromes, Immunologic deficiency syndromes, Antigen-antibody reactions

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